Break Out Unit Packs Before the Next Outbreak

The H1N1 influenza scare was stressful, but imagine if it multiplied:
Would your packaging deliver?

I joined Twitter in late March and soon started following FEMA’s femainfocus. I was interested in learning more about emergency and disaster preparations. On March 27, I posted the general tweet, “Can unit-of-use packaging and detailed labeling help first responders cope w/disasters like pandemic flu/bio-terror?” I also asked femainfocus, “What packaging innovations can be used

Daphne Allen

to prepare governments for disaster?” Someone from FEMA answered and said they’d look into it. We exchanged a few tweets, and on April 16, I asked femainfocus, “I would love any details on how to prepare pharma/med supplies for emergency planning, at state or federal levels. Thanks!”

And then H1N1 influenza broke out. I wasn’t the only one, then, tweeting about emergencies. In fact, most healthcare Twitters I was following had something to post about H1N1.

I originally started asking about disaster planning on Twitter because of reports of cities preparing for emergencies. For instance, in March a RAND Corp. report shared that a Cities Readiness Initiative was preparing cities with funding for mobile drug dispensing equipment. Also developing were relationships between public health officials and first responders. (To be clear, I wasn’t just twittering about preparations. I did pick up the old-fashioned phone a few times.)

But I really didn’t get any hints on how packaging could really play a role until I spoke to Carl Brewer, president of Upp Technology (Downers Grove, IL). He described the need to prepare in advance for the chaos that could ensue during emergency response. For more on how his company helped states prepare for and respond to the H1N1 outbreak, see page 17.
In the event of a health emergency involving masses of patients, “speed is critical to crowd control,” says Brewer. “It may sound over the top, yet these are the scenarios you have to prepare for. Public health officials have got to be able to answer the question, ‘How many patients can I process in an hour?’ If it’s done fast, everyone will be OK.”

Packaging—or a lack of it—could slow such emergency response. “When health officials receive supplies from stockpiles—called push packs—they’ve got to break those supplies into meaningful units and move them downstream to patients,” Brewer explains. “If they have to do a lot of repackaging, it slows down that movement.”

Automatic item identification could help ensure accountability, even during a crisis. “Item packaging and labeling with manifests by case and pallet preattached by the manufacturer would facilitate electronic conveyance of information to the CDC and thus the state,” explains Brewer. “All parties would be on the same page, with accurate data that are attached to the physical products. It would also lay the groundwork for recovery. In other words, what do we do when it all comes back? How do I know what I have? Where did it go? Was it used? Does it tie to doses administered? These are key elements of utilization that prevent pharmaceutical products from being misappropriated.”

Judging from the drop in H1N1 tweets, concerns seem to be subsiding. We shouldn’t, however, turn our focus away from the event just yet. Supplies were dispersed from the Strategic National Stockpile as planned, and cities put their own plans into action. But we did not see panic. Some pharmacies did run out of Tamiflu. But there were no fearful crowds filling the streets, no quarantines pushing patients to desperate measures of survival.

In other words, we had only a partial dry run, so we don’t fully know how well we were prepared.

Before the next flu season, we should extend our preparations to include unit packaging that eliminates repackaging. Also, unit-level identification would help officials deliver supplies to patients as quickly and equitably as possible.